1173 / 1245
Warsaw 2017
Sample DVC’s (Head and Neck)
at St. Luke’s, Beaumont & St. James’s Hospitals
Evaluation Form for Head and Neck
Patient Name:
<Full Name>
Patient ID Number:
<Patient Id 1>
Consultant:
<Primary Care Physician - Name (Default)>
Date of Birth:
Date:
<Current Date>
Diagnosis:
<All Primary Diagnoses - With Staging Info (Default)>
Dose
PTV1
Fractions Dose
PTV2
Fractions Dose
PTV3
Fractions
Gy
Gy
Gy
Dose
95%
107%
70
66.5
74.9
63
59.9
67.4
60
57.0
64.2
56
53.2
59.9
50
47.5
53.5
46
43.7
49.22
EVALUATION OF PTV 3DCRT
EVALUATION OF PTV/GTV – IMRT/VMAT
Dose
Optimal
Acceptable Variation
Result
D2% D50% D98%
PTV1
D
min
D
max
≥
95%
<107%
>90%
<110%
%
%
PTV2
D
min
D
max
≥
95%
<107%
>90%
<110%
%
%
Dose
Optimal
Acceptable Variation
Result
D2% D50% D98%
gtvpri70
V
95%
>100%
N/A
%
N/A N/A N/A
gtvnrt70
V
95%
>100%
N/A
%
N/A N/A N/A
gtvnlt70
V
95%
>100%
N/A
%
N/A N/A N/A
ptv1
V
95%
D
max
>99%
<107%
>95%
<110%
%
%
evalptv2
(NA for SIB)
V
95%
D
max
>99%
<107%
>95%
<110%
%
%
Evalptv3
(NA for SIB)
V
95%
D
max
>99%
<107%
>95%
<110%
%
%
evalptv1
cc @ 107% <1.5cc
< 6.5cc
cc
evalext-ptv
cc @ 110%
-
<1 cc
22
cc
Evaluation of OAR’s based on 1.8-2.0Gy per fraction
OAR
Dose
Constraint
Optimal
Acceptable Variation
Result
Toxicity Endpoint
Spinal cord
D
max
< 45Gy²²
< 50Gy
13
(0.2%)
<60Gy
13
(6%risk)
<69Gy
13
(50%risk)
Gy
0.2% myelopathy
Spinal cord 4mm D
max
< 47Gy
50Gy<1cc
22
Gy
Brainstem
D
max
D
1-10cc
<54Gy
3+23
60Gy
23
(0.03cc)
<59Gy
3
(risk<5%)
Gy
Gy
Neuropathy
/necrosis
Brainstem 3mm D
max
<54Gy²²
<60Gy²² (<1%)
Gy
Chiasm
D
max
< 54Gy¹
-3
55-60Gy¹⁺² (Risk3-7%)
>60Gy¹⁺² (Risk7-20%)
Gy
Optic Neuropathy
Chiasm 3mm D
max
<54Gy²²
Gy
Pituitary
D
max
< 45Gy
< 50Gy
12
Gy
Panhypo-
pituitarism
Temporal Lobe D
0-5cc
<69Gy
21
pharyngeal
constrictors
D
mean
≤50Gy
20
< 60Gy
20
Gy
Symptomatic
dysphagia and
aspiration
mandible - ptv
D
max
<70Gy
17
or
prescribed
dose
<73Gy to 1.5cc
<75Gy to 1cc
22
Gy
Oral cavity - ptv D
median
< 46Gy
16
Gy
Left
Right
Parotid
18
D
mean
<25Gy
17-19
<26Gy
17-19
Gy
Gy
Long-term salivary
function<25%
V
30Gy
<50%
17-19
Gy
Gy
Cochlea
D
mean
<45Gy
10-11
Gy
Gy
Sensory-neural
hearing loss
Eye
D
max
< 50Gy
4
Gy
Gy
Retinopathy
Lens
D
max
< 6Gy
4-5
Gy
Gy
Cataract
Optic Nerve
D
max
< 54Gy¹
-3
55-60Gy¹⁺² (Risk3-7%)
>60Gy¹⁺² (Risk >7-20%)
Gy
Gy
Optic Neuropathy
Optic Nerve 3mm D
max
<54Gy²²
Gy
Gy